Ed Palmer
09-22-06, 07:16 AM
Injury Insurance Surprise
Tom Philpott | September 21, 2006
Trauma Injury Insurance Not Limited To War Wounds
Service members, particularly Reserve and National Guard, might not understand yet how their military insurance has been enhanced to cover traumatic injury, whether suffered in war or at home, even while off duty.
The new Traumatic Injury Protection under Servicemembers’ Group Life Insurance (TSGLI) is still referred to as “Wounded Warrior Insurance” by proponents who pushed it through Congress last year with surprising speed.
Most of the 2700 recipients to date are wounded warriors, say officials. They qualified for TSGLI retroactively because of injuries sustained in combat areas since Oct. 7, 2001, the day U.S. troops first entered Afghanistan.
But for injuries incurred after Nov. 30, 2005, the phrase “wounded warrior” fails to capture the breadth of TSGLI. That’s because any service member, active or reserve, who has Servicemembers’ Group Life Insurance (SGLI) and suffers a traumatic injury can be eligible for the trauma pay.
A reservist, for example, might qualify if he loses a limb in a car crash while commuting to his civilian job. A National Guard member might qualify if she is paralyzed in a diving accident while on vacation.
Understanding this is important because members hit by traumatic injuries have to apply to their service for TSGLI payments. That’s why officials in the VA and DoD have embarked on an outreach campaign to get details on TSGLI to all service members.
Those wounded in war are being briefed on TSGLI during treatment and recuperation at major medical facilities, said Thomas Lastowka, director of insurance services for the Veterans’ Benefits Administration. “Our concern right now is primarily those people not on active duty who may be injured.”
Lastowka was one of several officials to testify this month before the Senate Veterans Affairs Committee on progress implementing TSGLI. Sen. Larry Craig (R-Idaho), committee chairman, explained again how three injured veterans first suggested a wounded warrior insurance rider to him last year. The departments of Defense and Veterans Affairs quickly got behind the idea and helped to draft legislation. It swiftly became law.
Payments help service members and families handle the extra expense and strain of adjusting to life-altering injuries. Payments range from $25,000 to $100,000, depending on severity of their trauma. Loss of a hand above the wrist, for example, would qualify a member for $50,000.
The most compelling testimony at the hearing came from Army Sgt. John Keith with the First Calvary Division at Fort Hood, Texas. Keith was injured by a rocket-propelled grenade in Iraq in November 2004. He and his Army doctors tried for weeks to save his injured leg. Finally, Keith agreed to an amputation so he could have an active life, he said.
He spent 60 days as an inpatient at Walter Reed Army Medical Center, and five months more, with his wife and two children, living in a single hotel room while he received physical therapy and recovered from his wounds.
Keith said he used his “savings and more” to keep his house near Fort Hood and pay its utilities bills while his family stayed with him in Washington D.C., relying on rental car and eating every meal out. As his bank account dwindled, Keith heard about a wounded warrior bill moving through Congress. He didn’t know if it would bring him financial relief, however, until told that TSGLI would apply retroactively to severe war wounds since the start of Operation Enduring Freedom in Afghanistan.
“I remembered thinking that my government really is trying to take care of my family,” Keith told senators.
Besides losing his left leg, Keith suffered a hearing loss, third-degree burns on his abdomen and spent 14 days in a coma. The $100,000 TSGLI payment allowed him to restore his savings, pay off most of his debts and buy his wife a new van. Even if his injuries cut short his Army career, Keith said, TSGLI has left him more ready for the future.
Since December, SGLI coverage has been automatic for service members. They have to opt out to avoid it. And SGLI automatically includes TSGLI coverage, which has added a dollar to monthly SGLI premiums.
Col. John Sackett with the Army Human Resources Command in Alexandria, Va., leads a staff that administers TSGLI for soldiers. So far, he said, 1,628 soldiers have received awards worth $101 million. Almost 90 percent of payments have gone to persons injured in Iraq and Afghanistan before Dec. 1 last year. Roughly half of all applications have been denied.
Michael L. Dominguez, principal deputy under secretary of defense for personnel and readiness, said the denial rate is reasonable for a program that encourages members to apply and let the system decide their eligibility.
Lastowka said VA’s claim experts have reviewed how the services process TSGLI applications and found every denial to be appropriate so far given documentation presented. Applicants can request reconsideration. If denied again, they can file a more formal appeal. Of 140 appeals filed so far, 17 have been decided in the applicant’s favor, Lastowka said.
He and Dominguez called TSGLI a great success. Jeremy Chwat, with the Wounded Warrior Project, a non-profit group formed to help severely injured veterans from Iraq and Afghanistan, agreed but with one exception.
A “major inequity” of TSGLI, said Chwat, is that retroactive payments don’t cover war-related injuries outside of combat zones. That impacts “a handful of wounded warriors” like Navy Seaman Robert Roeder who lost a leg aboard aircraft carrier Kitty Hawk. Roeder was injured by an arresting wire during flight operations as his ship steamed toward the Gulf of Arabia in January 2005 to participate in Operation Iraqi Freedom.
Tom Philpott | September 21, 2006
Trauma Injury Insurance Not Limited To War Wounds
Service members, particularly Reserve and National Guard, might not understand yet how their military insurance has been enhanced to cover traumatic injury, whether suffered in war or at home, even while off duty.
The new Traumatic Injury Protection under Servicemembers’ Group Life Insurance (TSGLI) is still referred to as “Wounded Warrior Insurance” by proponents who pushed it through Congress last year with surprising speed.
Most of the 2700 recipients to date are wounded warriors, say officials. They qualified for TSGLI retroactively because of injuries sustained in combat areas since Oct. 7, 2001, the day U.S. troops first entered Afghanistan.
But for injuries incurred after Nov. 30, 2005, the phrase “wounded warrior” fails to capture the breadth of TSGLI. That’s because any service member, active or reserve, who has Servicemembers’ Group Life Insurance (SGLI) and suffers a traumatic injury can be eligible for the trauma pay.
A reservist, for example, might qualify if he loses a limb in a car crash while commuting to his civilian job. A National Guard member might qualify if she is paralyzed in a diving accident while on vacation.
Understanding this is important because members hit by traumatic injuries have to apply to their service for TSGLI payments. That’s why officials in the VA and DoD have embarked on an outreach campaign to get details on TSGLI to all service members.
Those wounded in war are being briefed on TSGLI during treatment and recuperation at major medical facilities, said Thomas Lastowka, director of insurance services for the Veterans’ Benefits Administration. “Our concern right now is primarily those people not on active duty who may be injured.”
Lastowka was one of several officials to testify this month before the Senate Veterans Affairs Committee on progress implementing TSGLI. Sen. Larry Craig (R-Idaho), committee chairman, explained again how three injured veterans first suggested a wounded warrior insurance rider to him last year. The departments of Defense and Veterans Affairs quickly got behind the idea and helped to draft legislation. It swiftly became law.
Payments help service members and families handle the extra expense and strain of adjusting to life-altering injuries. Payments range from $25,000 to $100,000, depending on severity of their trauma. Loss of a hand above the wrist, for example, would qualify a member for $50,000.
The most compelling testimony at the hearing came from Army Sgt. John Keith with the First Calvary Division at Fort Hood, Texas. Keith was injured by a rocket-propelled grenade in Iraq in November 2004. He and his Army doctors tried for weeks to save his injured leg. Finally, Keith agreed to an amputation so he could have an active life, he said.
He spent 60 days as an inpatient at Walter Reed Army Medical Center, and five months more, with his wife and two children, living in a single hotel room while he received physical therapy and recovered from his wounds.
Keith said he used his “savings and more” to keep his house near Fort Hood and pay its utilities bills while his family stayed with him in Washington D.C., relying on rental car and eating every meal out. As his bank account dwindled, Keith heard about a wounded warrior bill moving through Congress. He didn’t know if it would bring him financial relief, however, until told that TSGLI would apply retroactively to severe war wounds since the start of Operation Enduring Freedom in Afghanistan.
“I remembered thinking that my government really is trying to take care of my family,” Keith told senators.
Besides losing his left leg, Keith suffered a hearing loss, third-degree burns on his abdomen and spent 14 days in a coma. The $100,000 TSGLI payment allowed him to restore his savings, pay off most of his debts and buy his wife a new van. Even if his injuries cut short his Army career, Keith said, TSGLI has left him more ready for the future.
Since December, SGLI coverage has been automatic for service members. They have to opt out to avoid it. And SGLI automatically includes TSGLI coverage, which has added a dollar to monthly SGLI premiums.
Col. John Sackett with the Army Human Resources Command in Alexandria, Va., leads a staff that administers TSGLI for soldiers. So far, he said, 1,628 soldiers have received awards worth $101 million. Almost 90 percent of payments have gone to persons injured in Iraq and Afghanistan before Dec. 1 last year. Roughly half of all applications have been denied.
Michael L. Dominguez, principal deputy under secretary of defense for personnel and readiness, said the denial rate is reasonable for a program that encourages members to apply and let the system decide their eligibility.
Lastowka said VA’s claim experts have reviewed how the services process TSGLI applications and found every denial to be appropriate so far given documentation presented. Applicants can request reconsideration. If denied again, they can file a more formal appeal. Of 140 appeals filed so far, 17 have been decided in the applicant’s favor, Lastowka said.
He and Dominguez called TSGLI a great success. Jeremy Chwat, with the Wounded Warrior Project, a non-profit group formed to help severely injured veterans from Iraq and Afghanistan, agreed but with one exception.
A “major inequity” of TSGLI, said Chwat, is that retroactive payments don’t cover war-related injuries outside of combat zones. That impacts “a handful of wounded warriors” like Navy Seaman Robert Roeder who lost a leg aboard aircraft carrier Kitty Hawk. Roeder was injured by an arresting wire during flight operations as his ship steamed toward the Gulf of Arabia in January 2005 to participate in Operation Iraqi Freedom.